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Research is driving the future of care across Ascension
Pharmacy residents at Ascension Sacred Heart Pensacola in Florida like Allison Durant, PharmD, and Anna Lee Petitt, PharmD, are engaged in research projects.
Research has led to many remarkable breakthroughs in medicine, from the discovery of penicillin to the development of anesthetics, therapeutics and vaccines. But in healthcare, research extends far beyond the laboratory.
Across Ascension, teams are using scientific methods of research to improve not only care processes but also the ways we live out our Mission every day by serving individuals and communities. Associates are harnessing the scale and scope of Ascension to support clinical advances; identify the most effective and meaningful ways to provide spiritual care; ensure that nurses are providing compassionate, personalized care in the most effective ways; and even determine how best to share messages and stories about the work of our tremendous caregivers and clinicians with consumers.
The goal is to make Ascension a national leader in applying research to better serve individuals and communities.
Research helps us know what patients hear and want.
To more fully realize Ascension’s Mission, we continue to pay close attention to the changing needs of those we serve. Caregivers and others on the front lines do it instinctively, one person at a time. But can it be done across larger population groups?
MARKETING RESEARCH LISTENS TO CONSUMERS
Marketing’s research and insights team, led by Chris Manley, Senior Director, Research and Analytics, Ascension, has been listening to consumers, patients, associates and other stakeholders for years and has continued engaging through the pandemic to better understand the changing healthcare landscape and consumer needs.
“This work gives people time, space and a platform to talk about what’s important to them,” Chris said. “Those conversations can be more challenging in a clinical setting. We create opportunities for people to tell us what they need to see and hear in order to choose Ascension for their care.”
Over the past five years, Chris and his team have spoken to about 2,500 consumers and associates in person (or more recently, by videoconference) and surveyed at least 50,000 people from across Ascension’s markets.
Nursing residents at Ascension Saint Thomas West Hospital in Nashville, Tennessee, participate in a research study to assess the ability of new nurses to clinically think and reason and the impact of virtual simulation on the development of those abilities.
“We’ve been able to learn from an incredible diversity of people on a broad range of topics,” said Anne Butler, Manager, Marketing and Communications, Ascension, who manages qualitative research. In late 2020, Chris and Anne tested seven ways of explaining the value of upcoming COVID-19 vaccines with consumers from six different Ascension markets. In July 2021 they spoke with hundreds of mothers in Indiana, Texas, Michigan and other markets to understand how Ascension can better explain high-risk maternity and pediatric services to people worried about complex care needs. A few years ago, associates and patients in Wisconsin, Tennessee and Florida provided their perspectives on how to ensure a smooth transition from legacy brands like Saint Thomas to a stronger Ascension Saint Thomas brand that’s backed by the resources of a national system. Members of the research and insights team keep their fingers on the pulse of our communities with a public opinion survey that runs all year, collecting thousands of opinions each quarter. “It gives us a good baseline understanding of how people see us and what they want most,” Chris said. “Whenever we need to understand something specific, we listen to the people we’re here to serve and Frederick Masoudi, MD support.”
Richard Fogel, MD
BUILDING A COMMUNITY OF SCIENCE INVESTIGATORS
Ascension’s clinical research team, led by Frederick Masoudi, MD, MSPH, Chief Science Officer and Vice President, Clinical Research and Analytics, Ascension, is building a program that will advance Ascension as a national leader in healthcare research and improve patient outcomes across our communities.
“As one of the nation’s largest health systems, we have the opportunity to be a national leader in clinical research,” said Dr. Masoudi. “This begins by developing the infrastructure to conduct trials across the organization and to serve as the basis of a learning healthcare system — an organization that studies its successes and opportunities to better inform how it delivers care.”
Dr. Masoudi and his team focus on a broad range of research taking place across the ministry, including research into systems and processes as well as clinical trials. The Ascension Clinical Research Institute and the Ascension Data Science Institute work together to facilitate national collaboration, support clinical investigators throughout the ministry, and put Ascension’s clinical data to work to identify opportunities to improve care across the continuum.
“Research is essential for Ascension to provide the highest levels of quality to our patients,” said Richard Fogel, MD, FACC, FHRS, Senior Vice President and Chief Clinical Officer, Clinical & Network Services, Ascension. “By aligning our research efforts nationally, we can tap into clinical analytics to identify new ways to advance care. Given our size, the new clinical research program has the potential to be one of the most impactful research programs in the world.”
Clinicians across Ascension conduct hundreds of research studies on new treatments and care strategies. The new clinical research program is standardizing our Institutional Review Board structures and Clinical Trials Management Systems around best practices, encouraging clinicians to better align their research efforts.
In addition, the program focuses on strengthening and creating new partner relationships with a broad range of
stakeholders — including academic institutions such as Dell Medical School at the University of Texas at Austin and the University of Alabama at Birmingham — which will grow the capacity and reach of research in Ascension.
“Across the ministry, our clinicians are making important discoveries,” Dr. Masoudi said. “By creating an enterprise-wide clinical research program that elevates their work and fosters collaboration, we can build a strong community of clinician scientists.”
RESEARCH ADVANCES SPIRITUAL CARE
Spiritual care serves an integral need across Ascension. As members of interdisciplinary care teams, chaplains are professionally trained individuals, uniquely prepared to provide spiritual care to patients and their families; support associates’ spiritual needs; and help build a culture that supports spiritually centered, holistic care.
Like many disciplines across Ascension, spiritual care and chaplaincy continue to move toward evidence-based practice. Mission Integration researchers such as Beth Muehlhausen, PhD, M.Div., BCC, LCSW, Research Manager, Ascension, are working to ensure that chaplains compassionately deliver care based on sound research and deliberate design.
Research projects helping to deliver an improved, holistic experience for patients, associates and the community include: • Two System-wide projects explored the efficacy and value of virtual spiritual care support for patients and their loved ones. • Two projects captured the experiences and responses of spiritual care related to the COVID-19 pandemic. One asked chaplains to journal how their roles changed as a result of the pandemic. The other followed about 20 directors over nine months to determine how their perspectives and leadership shifted. • A journal article featured a study that took place in Ascension Indiana looking into what mattered most to patients and loved ones in relation to spiritual care. • Another study involved interviewing a number of trauma surgeons, physician assistants and nurse practitioners about their experiences of spirituality in the context of their trauma work.
Dr. Muehlhausen leads a monthly Research Journal Club where participants review timely journal articles and invite guest speakers to discuss leading-edge research as a way for chaplains to become more research literate and stay apprised of current topics.
“In addition to ongoing support to patients and their families, chaplains have played an indispensable role in helping our associates and clinicians, especially during the pandemic,” said Timothy Glover, M.Div., Executive Vice President and Chief Mission Integration Officer, Ascension. “This spiritual care research is one of many ways we are leading through our Mission.”
Brenda Walls, MA, M.Div., BCC, Staff Chaplain, Ascension St. Vincent, Indiana, participated in a research project studying telechaplaincy with oncology patients. She also participated in a research project in which chaplains kept a journal of their experiences during the first few months of the COVID-19 pandemic.
PHARMACY RESIDENCY RESEARCH FOCUS
Similar to a physician’s residency program, the Ascension Rx residency program provides pharmacists who are one- and two-year postgraduate the opportunity to learn, grow, and contribute to patient care and operations. The opportunity to lead a guided research project is a key differentiator for the program.
Much of the research focuses on unanswered questions within clinical areas of focus and on expanding the role of pharmacy and how pharmacists practicing at the top of their licenses can benefit patient care.
While Ascension pharmacists have long been essential members of research teams, a multicenter focus is a new approach for Ascension Rx. This past year, residents from multiple markets worked collaboratively, enabling outcomes that spanned several care settings.
“Multicenter research within pharmacy residencies offers several advantages including an increase in the amount of data, a diverse patient population, further collaboration among pharmacy colleagues to enhance methodology, and more resources for statistical analysis,”
said Bradley Haan, PharmD, BCCCP, Clinical Pharmacy Specialist, Critical Care, Ascension Michigan.
A project led by then-resident and now associate Arsany Gadallah, PharmD, MBA, Clinical Specialty Pharmacist, looked at how virtual medication history technicians could reduce discrepancies in the records of patient medications. The study — published in the April 19, 2021, issue of the International Journal of Clinical Pharmacy — found that the rate of incomplete medication histories was significantly lower for virtual pharmacy technicians than for other clinicians (6.7% vs. 62.5%, respectively — a marked improvement).
“The residency project, whether research or quality improvement in nature, aims to evaluate novel and/or alternative solutions to current problems impeding patient care,” Dr. Gadallah said. “By conducting and leading the project, the resident holds the opportunity to change contemporary medical practice and directly impact patient outcomes.”
“We’re investing in the future of pharmacy and growing future leaders. The program is also becoming a recruitment and retention enhancer,” said Lynn Eschenbacher, PharmD, MBA, FASHP, Vice President, Medication Management, and Chief Pharmacy Officer, Ascension.
DELIVERING NURSING RESEARCH TO THE BEDSIDE
The Ascension Nursing Center of Excellence (COE) was established to make Ascension the best place to practice nursing by transforming how our nurses and nursing support professionals care for ourselves and others. And research is central to that work.
“As nursing becomes a Ministry-wide Function, our nursing community will achieve greater coordination, enabling our programs to scale and spread across the care continuum,” said Karen Springer, MSN, RN, Executive Vice President and Chief Nursing Executive, Ascension. “Nurses will have greater opportunities to lead the transformation of healthcare.”
To deliver on this ambition, the Nursing COE is extending to all Ascension nurses the opportunity to advance the science of nursing. This will contribute to nursing not only within Ascension but also across the nursing profession and positively impact outcomes for nurses, patients and the communities we serve.
Led by Mary Sitterding, PhD, RN, CNS, FAAN, Vice President, Nursing Research, Evidence-based Practice and Implementation Science, Ascension’s nursing research team has created programs of research and research priorities to advance Ascension nursing as a national leader in health services research. This research is informed by the Ascension Strategic Plan, Nursing Dynamic Plan, Future of Nursing 2020-2030 and the National Institutes of Nursing Research.
“Nursing research is the lens through which the most pressing challenges in healthcare can be systematically examined to address priorities in models of care delivery, population health and health equity,” said Melissa Faulkner, PhD, RN, FAAN, National Senior Director of Nursing Research.
Melissa joined Ascension in October to strategically execute on the team’s programs of research. She brings a wealth of experience, including a number of endowed faculty and leadership positions, extensive research contributions through National Institutes of Health (NIH) funding, and experience as a co-investigator for training
— MARY SITTERDING, VICE PRESIDENT, NURSING RESEARCH & EVIDENCE-BASED PRACTICE, ASCENSION
early-career nurse scientists through an NIH grant. One of many capacity-building opportunities for nurses is the Ascension National Nurse Affinity – Nurse Research group, which represents all markets and Mary Sitterding, PhD, nursing roles. The group connects RN, CNS, FAAN nurses at the point of care with associates at the highest level of decision making supporting nursing programs of research.
“Providing capability-building research competencies among nurses places them at the interprofessional research table, enabling the nurse to become an equal contributor and partner in the development, publication and impact of clinical and health services research,” Mary said.
Nursing research program areas include workforce (joy in nursing, practice-ready nurse graduates, technology- enabled nursing, care models of the future), safety (culture of safety, process reliability, and nurse recognition and rescue), and health equity (social determinants of health, social determinants of learning and diversity in nursing).
Ascension’s 60,000 nurses are poised to contribute meaningfully to advancing the practice and science of nursing.
“Through our enterprise-wide nursing function and developing research infrastructure, we are well positioned through collaborative partnerships to positively impact through discovery those we serve and serve beside,” said
Amy Wilson, DNP, RN, CPHQ, Senior Vice President,
Nursing Center of Excellence.
ASCENSION STUDIO’S HUMAN-CENTERED APPROACH
The Ascension Studio’s purpose is to create technologyenabled services for Ascension that are scalable, people-centered, and best-in-class for patients and caregivers to meet the demands of today and the future.
From products like Video Chat for remote visits between patient and clinician to a self-screening Screen & Go tool for COVID-19 and a Surgery Scheduling Manager for streamlined surgical scheduling, the Studio works toward solutions that improve both the patient and the clinician experience. Members of the Studio also collaborate with teams across Ascension, such as Ascension Rx and other service-based solutions, to improve the healthcare journey.
When the studio aims to solve a particular healthcare or business challenge, its Experience Research and Design (xRD) team employs a diverse array of research methodologies to gauge user needs and expectations. This includes field studies, observations, interviews, focus groups, surveys, video journaling, journey mapping, design co-creation sessions and workshops, usability testing, and more. They engage early and often with those who will eventually use the product or service, creating an array of data points and insights that can influence design, development and implementation. This exploratory research at the beginning of the design process helps ensure that the solution meets both current and future user needs.
The xRD team also seeks to understand clinical workflows and patient journeys. Whether the goal is reducing the amount of time clinicians spend in front of screens instead of providing patient care, or eliminating consumer healthcare barriers, technology can have a positive impact, as can human behavior and psychology, which is why the research team includes associates from backgrounds such as anthropology, psychology and human factors. The team is focused on identifying the right solution to the right problem and creating a differentiated — and better — customer and patient experience.
“We take a human-centered approach. We talk to actual patients, consumers, clinicians and staff so we can understand what solutions and designs may be the best fit for them,” said Michael Chapman, Senior Director of Experience Research for the Ascension Studio. “We’re trying to solve problems for those that we are privileged to serve.”
And that, after all, is the goal behind all of Ascension’s research efforts.
